Top 5 Fridays! 5 Things I Learned Treating Division I and Pro Athletes | Modern Manual Therapy Blog

Top 5 Fridays! 5 Things I Learned Treating Division I and Pro Athletes

My practice in Houston officially started this week, treating some athletes at Rice, one coach (multiple world record holder, with several golds), and a few pros. This is what I learned about treating this population of track athletes.
left to right, Adrian Chavez, my business partner, Coach Bill "Superman" and yours truly

1) Many of them have the same movement asymmetries that your average patient would
  • the javelin thrower who was told everything from ulnar neuropathy to needing a Tommy John Surgery on his throwing arm had
    • major loss of both IR and ER on the right shoulder
    • scapular instability
    • thoracic rotation limitation to the right
    • ASLR DN (45 deg) on the left, FN with passive
    • inability to activate right to left diagonal motor pattern
    • moderate limitations in left hip IR and left tibial IR
    • PLUS, severely limited and painful with right ulnar neurodynamics
  • is it any wonder his right medial elbow was bothering him? - his most threatening position (ulnar neurodynamics) is also his throwing position
  • putting that all together (which was all quickly corrected as he was a rapid responder in all areas), he was able to throw with no discomfort or pain later that day
2) Division I athletes also cancel or no-show like your average patients
  • all I know is someone is going to get an earful from their coach
3) passive modalities offered all around
  • granted, I was only around in the training room for 2 days, but other than my treatment, all I saw was ice, heat, whirlpool and ultrasound
  • to be fair, I am not sure if they were injured, sore, or just recovering after working out
4) Pros who are sponsored still don't replace their shoes often enough
  • the two decathletes that I saw each had shoes that were 4-5 months old
  • one had the plantar surface of the heel peeling off, with the heel peeling off of the counter on both shoes!
  • the Gait Guys Level 1 Shoe Fit course really helped in this aspect
5) Even with good manual care, not enough correctives or self resets are given for HEP
  • many of the athletes I saw who were treated, improved for 24-48 hours, but then went rapidly downhill
  • however, self assessment or correctives/self resets, you can't expect the improvements to last
  • I took care of this and gave each of them self assessments (example above)
    • MRE testing for shoulder + shoulder extension resets
    • thoracic rotation testing in sitting + thoracic whips
    • hip IR M's assessment + EDGE Mobility Band self IR
    • tibial IR seated assessment + EDGE Mobility Band functional IR mobilization in half kneel
I had a great time and everyone who I met and worked with was amazingly nice (no surprise in the south) and all had great attitudes. They were all really into learning pain science, modern manual therapy mechanisms, and self assessment and treatment.

 pre tx - quad shaking ASLR

after a bit of dry needling and instruction on diaphragmatic breathing with TA activation
Keeping it Eclectic...


  1. Hey Dr. E, what do you mean when you say "which was all quickly corrected as he was a rapid responder in all areas"?

  2. Being a Rapid Responder means he has the ability to be reset neurophysiologically in the problem areas I mentioned. As in a little IASTM and FDN restored asymmetries to FN

  3. Hi Dr. E! What is your test for assessing ability to activate the diagonal motor patterns? Thanks!

  4. Philip, it could be anything from rolling patterns, to Baby Get Up (mini version of Turkish Get Up), or Palloff press, to anti-rotational plank with reach to opposite shoulder. I'll try and shoot them for the OMPT Channel as I am working on higher level "chains' assessments for those who are moving symmetry